Laser treatment for bladder cancer

Kontakt

Praxis für Urologie
Dr. med. Aref El-Seweifi
Forum Zehlendorf
Teltower Dam 35
D-14169 Berlin
Deutschland

Tel.: +49 30 804 90 950
Fax: +49 30 804 90 951
info@masculine.de

Laser treatment for bladder cancer

The steady and lastly out standing development in the biochemistry and physics of light and optics has been polarised in the last ten years in the use of early detection and deliniation for the treatment of bladder cancer which provides a sophisticated method for the improvement of the quality of life of the patients.

Bladder cancer is a disease that affects the lining mucous membrane of the bladder due to its contact with some hazardous substances. This results in hyperactivity of the cells that grow unlimited and on the costs of the surrounding cells and the whole body. This starts first slow and superficial. The early detection of this growth on the primary cellular level enables its limitation and early treatment with simple methods aiming at achieving a better quality of life and increasing the intervals of follow up and avoiding the necessity of a more aggressive treatment modality if ever needed. This is achieved by the use of photodynamic diagnosis. The defined area of cancer may then be coagulated with Nd-YAG laser before and after its resection.

Stages of bladder tumor
The stage of bladder cancer is dependent on the depth of penetration
into the bladder wall. It is microscopically divided into Ta to T4.
The higher the number the deeper the penetration depth of the tumor

Who qualifies for the operation?

Patients that have a bladder cancer as revealed on a chronic resistant bladder infection or unclear bladder irritability. The detection of red blood cells under microscope or the observation of blood in urine is an indication for the early detection of the cancer which is resected if present.

Patients who have a histologicaly documented cancer profit in that the lesion is very accurately and completely resected from their bladder with minimal loss of blood and a better healing and convalescence.

How does the operation work?

The patient lies on the back. A local anaesthesia with a lubricant gel is installed into the urethra. The bladder is inspected endoscopicaly and the cancer, which is defined with the photodynamic diagnosis, is resected under anaesthesia using special endoscopes and under video control. Biopsies are taken from different areas. The lesions are sent to the histopathologic examination. The area may then be treated with continuous Nd-YAG laser to insure complete healing of the lesion or the suspected area if this is necessary. The duration of the procedure is 30-45 minutes. If the lesion is not an early one and the resection area is wide, it may be necessary to insert a catheter for a day.

Healing:

The procedure is very simple and sure. It is done on out patients basis. In case of wide lesions it may be mandatory to stay in the hospital for some days. Healing is usually smooth due to the accuracy of the method and the advantage of the use of laser.

The urine coming out of the catheter may be pink tinged which is a normal happening. Sometimes it is necessary to perform a continuous wash to the bladder through the catheter to prevent the development of blood coagulation and obstruction of the catheter.

How to prepare for the operation?

Please see chapter on preparation of the patient.


Flurezierendes Blasenkarzinom Das Tumor ist deutlich mittels Flurescenz früherkannt und dargestellt, photodynamische Diagnostik genannt. Die Tumorregion ist rot und die normale Bekleidung der Blase blaufarbig. Tu = Tumor	Behandelter Blasenkrebs Das Tumorbett ist flach nach der Abtragung durch die Harnröhre. Tu = Tumor


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Frequently Asked Questions (FAQ):
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What is bladder cancer?
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It is a sort of an aggressive metabolic activity taking place into the cells lining the bladder. These cells divert the energy of the body to them and start to invade the wall of the bladder and the surrounding organs through blood, lymph and directly to change the function of the invaded tissues.
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What are the stages of bladder cancer?
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They are superficial, locally invasive and distantly invasive. It is our aim to detect the case in its early superficial stage to stop it or put the cells under medical and surgical control to improve or keep the quality of life.
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Is the procedure painful?
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No, It is only time consuming but guarantees the best possible diagnosis and results.
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Does the laser treatment cure cancer of the bladder?
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No, it does not. It only enables the very precise depletion of blood from the cancer area enabling the bloodless resection. The coagulation of the base of the tumor results in closure of the lymph and blood vessels of the area preventing further transport of the cancer cells through the coagulated vessels. Similar results could be achieved by the high frequency current as well.
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Does the laser treat the infiltrations and distant metastasis?
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No, it does not. It enables the destruction of the cells of cancer as deep as possible in the bladder wall which is not possible by the conventional methods. It is important to have the bladder deeply resected to be able to stage the degree of infiltration of the disease.
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What are the complications of the laser treatment?
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If the laser is too deeply applied, it may injure the intestine which can be avoided by the proper application. The bladder capacity should be considerable to prevent the shrinkage of the bladder if it is originally small.
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What are the advantages of the laser treatment?
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It is a simple and safe method. It enables the removal of cancer with a minimal loss of blood. It seals the routes of metastasis of the cancer locally. The operation is short and the hazards are minimal.
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Is the laser treatment of bladder tumours necessary?
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No, It may be used when indicated and applicable but the same results can be obtained by the conventional high frequency current.